Provider Demographics
NPI:1407949928
Name:LEMUS, BONNIE FRASER (NP)
Entity Type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:FRASER
Last Name:LEMUS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9960 WHEATLAND AVENUE
Mailing Address - Street 2:
Mailing Address - City:SHADOW HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91040-1445
Mailing Address - Country:US
Mailing Address - Phone:323-816-8903
Mailing Address - Fax:
Practice Address - Street 1:9960 WHEATLAND AVENUE
Practice Address - Street 2:
Practice Address - City:SHADOW HILLS
Practice Address - State:CA
Practice Address - Zip Code:91040-1445
Practice Address - Country:US
Practice Address - Phone:323-816-8903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN306022363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care